Help Paying Your Bill

Discount Payment and Free Care Summary

Henry Mayo Newhall Hospital (HMNH) offers financial assistance to patients who are uninsured (self pay) or insured patients with high medical costs. Please visit the Patient Access Services Department in the Main Admitting area or call 661.200.1050 between the hours of 7:30 a.m. – 4 p.m., Monday through Friday.

To view the full Plain Language Summary for Financial Assistance Program (FAP), Discount Payment/Free Care CLICK HERE.

Applications

Financial Assistance Program (FAP) - Click Here

Programa de Asistencia Financiera en Español - Clic Aqui

Financial Assistance Application - Click Here

Programa de Asistencia Financiera Applicacion en Español - Clic Aqui

Click here to learn about Financial Policies

Eligibility Requirements

Financial assistance is provided on a sliding scale basis based on the following eligibility criteria:

• Individual or household unit income - up to 400% of the FPL. Employment status shall be considered when determining income levels. Prior income levels may not meet the established poverty level guidelines; however, recent unemployment should be considered when evaluating the current source of income.
• Individual or household unit net worth - up to $250,000 (excluding net worth in primary homes of up to $500,000 and retirement or deferred compensation plans; disregard the first $10,000 of a person’s monetary assets (i.e., cash and investments) and half of monetary assets thereafter). When reviewing net worth, other financial obligations such as high medical bills should be considered. Patients with high net worth that would otherwise disqualify them for financial assistance may be considered for eligibility if they have, for example, uninsured catastrophic health care costs that would significantly reduce their net worth. High medical costs shall mean:
  • Annual out-of-pocket costs incurred by a patient at HMNH that exceed the lesser of 10% of the patient’s current Family income or Family income in the prior 12 months;
  • Annual out-of-pocket medical expenses that exceed 10% of the patient’s Family income, if the patient provides documentation of the patient’s medical expenses paid by the patient or the patient’s Family in the prior 12 months.
• Self-pay patients admitted through the Emergency Department with insufficient information provided to fully evaluate financial assistance and eligibility tests, for whom the ability to paycannot be reliably determined, will be classified as charity. If information becomes available later that would disqualify the patient from meeting the financial assistance criteria, then the patient account will be reclassified to the appropriate payer class.
• Patients who presumptively qualify for Medi-Cal, but where HMNH does not receive payment for their entire stay are eligible for charity care for denied stays, denied days of care, and noncovered services. These denials and any lack of payment for non-covered services provided to Medi-Cal patients are to be classified as charity. These patients are receiving the service, and they presumptively do not have the ability to pay for it. In addition, Medicare patients who have Medi-Cal coverage for their co-insurance/deductibles, for which Medi-Cal does not make payment, and Medicare does not ultimately provide bad debt reimbursement will also be included as charity. These patients are receiving a service for which a portion of the resulting bill is not being reimbursed.
• Trauma services rendered to patient medical conditions meeting the definition of billable trauma care, per our trauma care agreements with the County of Los Angeles and the State of California, will be classified as charity care. These patients will not be billed for their services.
• Patients who are eligible for government sponsored, low-income assistance programs (i.e., Medi-Cal, out of state Medicaid, California Children’s Services and any other applicable Federal, State or local low-income program) are presumed to be indigent. Therefore, such patients may be considered as presumptively eligible under the FAP when payment is not made by the governmental program. Rationale for such presumptive determination shall be documented in the patient account.

How to Apply

Please submit the requested documents to Patient Access Services in person or by mail to:

Henry Mayo Newhall Hospital

23845 Mc Bean Pkwy

Valencia, CA 91355.

Attn: Patient Financial Services

You will receive a determination of Eligibility for Financial Assistance letter within thirty days after we receive a completed application with appropriate supporting documents.

If you need any further information or assistance in completing the application, please make an appointment to come to the hospital at Patient Access Services, Main Admitting, or call 661.200.1050, Monday through Friday, 8 a.m. through 5 p.m. and a representative will assist you.

Hospital Bill Complaint Program

The Hospital Bill Complaint Program is a state program, which reviews hospital decisions about whether you qualify for help paying your hospital bill. If you believe you were wrongly denied financial assistance, you may file a complaint with the Hospital Bill Complaint Program. Go to HospitalBillComplaintProgram.hcai.ca.gov for more information and to file a complaint.